The overall goal of this planning grant is to improve the quality and safety of the specialist referral process by translating knowledge gained from Commonwealth Fund supported pilot research on information needs of physicians and patients in the specialist referral process into the practice environments at the University of Kentucky Medical Center (UKMC) and rural physician providers throughout the Commonwealth of Kentucky. The long-term goals of our HIT planning are to use our research findings to create an electronic information exchange process that will: (1) improve the coordination of patient care between the referring physicians in rural Kentucky and the specialist providers at UKCMC; (2) decrease the potential for patient error in the referral process; (3) meet the information needs of patients; and (4) improve patient and physician satisfaction with the referral process. We have developed partnerships with rural physician practices and will: (1) validate the research findings from our study; (2) identify essential technological needs for accessing and sharing data and information in a way that allows the patient, patient's primary care provider, referring physician, specialist physician, and other healthcare providers to efficiently and effectively access information needed to coordinate their care; (3) develop an implementation plan that includes the key functional goals, strategies, resources, timelines for implementation of the electronic referral process; and (4) develop a human change management plan that parallels the diffusion of information technological innovation. The planning will expand the work on transmitting referral information electronically in a closed health system at Brigham & Women, to an open system that draws patients from rural Appalachia. The HIT initiative will serve as a model for health care providers in rural communities across Kentucky, and knowledge gained from this planning effort will inform the referral process between health care providers in rural and urban communities across the nation.